ESI XXXI: OR applied to health in a modern world

At the early stages of a research career, it is vital to have a forum to discuss and learn from peers and experts. The Association of European Operational Research Societies (EURO) provides one such form through the EURO Summer and Winter Institutes.

From the 11th to the 20th of June 2014, the Italian and United Kingdom OR societies organised a EURO Summer Institute (ESI) particular focused to healthcare research. The theme of this ESI was “Operational Research applied to Health in a Modern World” and it took place in the stunning setting of Bard, Italy.

This special issue is the second special issue resulting from the ESI. The first (Aringhieri et al, 2016), published in Operations Research for Healthcare, consisted of contributions regarding a single aspect of a healthcare system exploiting innovative OR modelling and solution approaches. This special issue considers work that spans across the healthcare system and/or comparisons of methodological approaches.

As we stated in Aringhieri et al (2016) OR modelling for health care has developed with the complexities of the modern world and data is now an abundant resource which underpinned the theming of the ESI. To ensure the efficient and precise use of these resources in a patient-centred manner, it is vital to consider the health system as a whole which is the subject of the articles in this special issue.

One of the main challenges in health systems analysis is therefore the use of big data to support public health policies. The healthcare sector is characterised by the collection, storage and processing of immense amounts of data, which are generated by an increasing plurality of healthcare providers. Furthermore, they can be integrated using data coming from different sources, such as social networks, environment surveillance systems, real-time traffic systems, and so on. Big data in healthcare can enable the development of more detailed health system models since they can replicate, step by step, the flow of each single patient entering in the NHS. This opens the possibility for the development of new integrated modelling approaches.

As described by Aringhieri et al (2016), following the selection process for the ESI, eighteen participants were selected from 46 expressions of interest from all over the world. Furthermore, three participants were selected under a partnership with the Canadian CREATE program (Collaborative Research and Training Experience) in Healthcare Operations and Information Management. The final list of delegates able to attend was as follows:

  1. 1.

    Papiya Bhattacharjee, IIT Kharagpur, India

  2. 2.

    Nardo Borgman, University of Twente, the Netherlands

  3. 3.

    Aleida Braaksma, Academic Medical Center, University of Twente, the Netherlands

  4. 4.

    Omar El-Rifai, École Nationale Supérieure des Mines de Saint-Étienne, France

  5. 5.

    Anna Graber-Naidich, University of Toronto, Canada

  6. 6.

    Paolo Landa, Università degli Studi di Genova, Italy

  7. 7.

    Mário Amorim Lopes, Universidade do Porto, Portugal

  8. 8.

    Manolitzas Panagiotis, Technical University of Crete, Greece

  9. 9.

    Melanie Reuter, Karlsruhe Institute of Technology, Germany

  10. 10.

    Ines Raschendorfer, University of Kaiserslautern, Germany

  11. 11.

    Paolo Tubertini, Università degli Studi di Bologna, Italy

  12. 12.

    Pieter van den Berg, Delft University of Technology, the Netherlands

  13. 13.

    Maartje van de Vrugt, University of Twente, the Netherlands

  14. 14.

    Houra Mahmoudzadeh, University of Toronto, Canada

  15. 15.

    Jennifer Morgan, Cardiff University, United Kingdom

  16. 16.

    Sheetal Prakash Silal, University of Cape Town, South Africa

  17. 17.

    Julie Vile, Cardiff University, United Kingdom

  18. 18.

    Jacqueline Wirnitzer, Karlsruhe Institute of Technology, Germany

A further three self-funding guest students were also welcomed to the ESI: they were Anne Zander, Karlsruhe Institute of Technology, Germany; Davide Duma, Università degli Studi di Torino, Italy; and Saber Mashaal, Medical Institute, Pulmonology, Al Ain Hospital, UAE. These guests were able to attend talks and participate in discussions and social events; they were not, however, permitted to present papers.

The format of the ESI included three components: tutorials, presentations, and discussions. The main body of the institute revolved around the presentation of papers by the attendees (these papers had previously been reviewed). Following this presentation, every paper was discussed not only with the other attendees but also senior experts. The list of senior experts is as follows:

  1. 1.

    Roberto Aringhieri, Università degli Studi di Torino, Italy

  2. 2.

    Sally Brailsford, University of Southampton, UK

  3. 3.

    Vito Fragnelli, Università degli Studi del Piemonte Orientale, Italy

  4. 4.

    Paul Harper, Cardiff University, UK

  5. 5.

    Vincent Knight, Cardiff University, UK

  6. 6.

    Stefan Nickel, Karlsruhe Institute of Technology, Germany

  7. 7.

    Marion Rauner, University of Vienna, Austria

  8. 8.

    Giovanni Righini, Università degli Studi di Milano, Italy

  9. 9.

    Honora Smith, University of Southampton, UK

As well as these, the senior experts all gave further talks/tutorials showcasing some areas of their expertise.

For more details about the ESI, please refer to the official report published on the EURO website:

As stated previously in this special issue, we have collected all the contributions that cover more than one aspect of the healthcare system and/or comparisons of methodological approaches. This special issue is composed of four papers which we are excited to describe here.

Two stalwarts of the OR simulation toolbox include Discrete Event Simulation and System Dynamics which is considered by Morgan et al (2016). In particular, this paper offers a reflection on the methodological implications of mixing both of these approaches. The paper uses a radiotherapy treatment centre as the background which is particularly suited due to the multi-stage process. The reflections and discussions will be of interest to all modellers aiming to combine approaches.

The next paper in this special issue by Silal et al (2015) will also be of interest from a methodological point of view. In this paper, disease transmission dynamics using compartmental models of varying levels of complexity are considered and compared to data. Some initial conclusions seem to indicate that simpler models are more appropriate, however, the main take-home message is to be sure to use the appropriate model for the problem considered. The mathematical models and their comparisons should be of interest to not only epidemiologists but all OR researchers.

Lopes et al (2016) move to not compare methodologies but international health care systems. This comparison is technically challenging due to the differences between countries. This paper discusses a novel approach of clustering countries which makes for the grouping of similar countries (across a variety of dimensions) possible. Using this approach, data from the World Health Organisation are investigated to illustrate how the proposed methodology can be used to best inform policy. This paper should be of interest to data miners and policy researchers alike.

The final paper of the special issue is by Lodi et al (2015). This paper considers funding of medical research, and in some sense we return to the first paper of the issue (Morgan et al 2016) as a System Dynamics model is considered. This model is used to obtain parameters based on the need for medical specialisation. These are in turn used to define an integer program optimisation model that returns an optimal allocation of grants. The paper considers various scenarios that should be of interest across the methodological and applied point of views.

To summarise this editorial, we feel that the ESI was a great success and would like to thank all participants for making it so. The papers in this special issue and by Aringhieri et al (2016) prove that the healthcare modelling landscape has a very bright future. Furthermore, our thanks go to the editors of Health Systems for their support in putting this special issue together.


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Correspondence to Vincent Knight.

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Aringhieri, R., Knight, V. & Smith, H. ESI XXXI: OR applied to health in a modern world. Health Syst 5, 163–165 (2016).

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